New Documentary Shows What A Humane Approach To Addiction Actually Looks Like

WASHINGTON -- In the early moments of "Chasing Heroin," a new "Frontline" documentary that will air Tuesday on PBS and online at 9 p.m. EST, a police van pulls down a Seattle alley and stops near a pair of heroin addicts. A cop gets out of the van and assures them that he means no harm.

The officer merely wants to know who the addicts are and offer them connections to a social worker -- and, maybe down the line, to treatment. Decades into the war on drugs, the exchange is jarring for what it doesn’t include: an arrest.

"Frontline" cameras spent a year chronicling not only the quiet devastation of the opioid epidemic but also the attempts of police officers and social workers, public defenders and prosecutors, to save the lives of addicted people without locking them up.

Disappointments and setbacks are frequent in "Chasing Heroin." It’s because of these disappointments that the film achieves a clear-eyed, even vital importance, especially if you know someone struggling with addiction. The opioid epidemic may be decades in the making, but the public health solutions -- specifically in the forms of medication-assisted treatment through methadone and buprenorphine -- are still trying to take root and gain public acceptance.

You’ll worry about Cari Creasia, the PTA mom turned opioid addict and drug mule, and Johnny Bousquet, an addict yearning for a second chance. A single car ride to a methadone clinic will feel like a huge win. At the very least, one thing is certain: You won’t wish any of the addicts were in prison.

This past weekend, The Huffington Post did a short Q&A over email with Marcela Gaviria, the director, writer and producer of "Chasing Heroin," in anticipation of Tuesday's premiere. HuffPost spoke with Gaviria about her film, how it came together and what she learned from making it.

What got you interested in making "Chasing Heroin"?

I began my career at FRONTLINE reporting on the drug wars. I was born and raised in Bogota, Colombia, and had cut my teeth following the cocaine wars, so it was natural territory for me.

The heroin epidemic first came onto my radar back in 2013, after I heard about the spike of overdoses in places like New Hampshire and Vermont. I pitched this story for several years and was really pleased when I finally got the green light to pursue the story.

How did you arrive at the public health/harm-reduction storyline? Did you set out to tell that story?

When we set out to tell this story, I kept thinking of something [Drug Enforcement Administration] Special Agent Bob Stutman told us 15 years ago while making "Drug Wars" for PBS FRONTLINE. He said, “We, as a nation, should have learned the lesson a long time ago that you cannot depend on law enforcement to solve the problem.” I wanted to understand if that had changed since I last covered the drug wars. Did the drug war logic still endure? Did punitive approaches still hold sway? Were any cities embracing a decriminalization model? What was new and novel?

The best reporting that we found, to be blunt, was yours. I was very tempted to head to Kentucky and Indiana to cover the response to the HIV spike, but also wanted to try to till new territory.

Seattle and LEAD [Law Enforcement Assisted Diversion] seemed to encapsulate a shift from the old war on drugs to new ways of dealing with demand. We settled there for budgetary and logistical reasons, deciding to explore this terrain in one place.

The original idea was to find two participants in the LEAD program and follow them over time. Along the line we decided that it would be important to show a counterpoint, in drug courts, which is a more prevalent model.

One of the most compelling people that you followed was Cari. How did you find her? What drew you to her story?

I sat in on several sessions of King County drug court to find possible participants. I was looking for someone who had begun abusing opioids and then moved on to heroin, so that I could tell the backstory of the opioid epidemic. But the few characters I was drawn to in drug court actually dropped out of the program before I started filming. So, in speaking to the team that runs program for alternatives, they suggested I contact Cari Creasia. And once I heard the details of her life story -- from soccer mom to drug house junkie -- I couldn’t resist.

In the film, you show how the LEAD program works and how it sometimes doesn't work, especially when addicts have to wait for treatment or are turned away from treatment. Why aren't doctors certified to prescribe buprenorphine incorporated into the LEAD program more? Is there a shortage of certified doctors in Seattle?

This is interesting territory, and I wanted to do more on it, but ultimately decided the best way to broach it in the film was through the providers in each character's life. I think there is an overall shortage of buprenorphine-certified doctors in the country, but [I] don’t think Seattle is unusual in any particular way.

I'm curious about what you think of the criticism mentioned in the film that the media is paying attention to the epidemic because it's mostly affecting white people? And that the harm-reduction approach is only becoming mainstream because there are white addicts? In my own reporting on the subject, I've found that addicts still have an incredibly difficult time accessing services and that the more punitive approaches still hold sway in a lot of communities. I think you found that as well with the town that rejected the methadone clinic. And you touch on this with the segment on drug courts.

I think it’s clear that we are starting to see a shift in that cities are increasingly willing to embrace harm-reduction approaches -- from the Angel program in Gloucester, Massachusetts, to LEAD, which is being replicated in more than 30 cities now. I do agree with former Attorney General Eric Holder that when things affect a majority community, politicians pay greater attention and are more willing to try new approaches.

That said, you’re right, many communities are still not turning the corner. It’s true of Bremerton and true of many drug courts in Washington state that do not offer medication-assisted treatment.

After spending a year with LEAD, how do you think it could be improved?

You can’t ask LEAD to be responsible for improving the services that they divert their clients to, but it’s clearly a flaw in the system. I also think they could work on finding ways to help their clients find jobs once they are in recovery. It’s very hard for someone like Johnny Bousquet to stay clean if he can’t become [a] productive member of society.

What surprised you most while working on the film?

I was shocked by the lack of availability of services and by the difficulties people have accessing treatment. Too much is stacked against an addict in recovery.

What do you think parents who are struggling with addicted children need to know?

What’s upsetting to realize is that there is no Consumer Reports for addiction treatment. It’s so hard to figure out what to do and where to send your kid.

Having spent a year covering his story, I’ve come away believing methadone and Suboxone are important options in the road to sobriety, and there is still too much stigma attached to using those medications.

What's the scene in the film that still haunts you?

It’s hard to choose one scene, but this is definitely one of the most emotionally intense films I’ve ever worked on. I really grew to care for the people I profiled. And I think I’ll always be haunted by worry for them. Perhaps in five years' time I can come back and film them again and see how things are working out for them.

As far as scenes, it’s hard to forget Kristina shooting up as she carries on about her future life. I still am touched every time Dr. Capp chokes up when he talks about Johnny’s desire to do anything to get clean.

What do you want viewers to take away from the documentary?

I hope they realize that this epidemic is not unlike the AIDS epidemic of the 1980s. Then, as a nation, we rallied to come up with solutions. We aren’t doing enough now. Access to treatment is inadequate. Services stink. Relapse rates are way too high. There aren’t enough studies to tell us what works and what doesn’t work. Over half a million people have died from opiate overdoses in the last 15 years. We clearly can do better.

What do you think needs to change in our public policy in dealing with the heroin epidemic?

The Obama administration is reviewing the restrictions on prescribing for medication-assisted treatment, and relaxing those rules would be a good start. We could also require insurance plans to include coverage for more than 30 days of inpatient treatment. That’s clearly not enough time to get someone clean. And access to medication-assisted treatment should not be denied.